Chylothorax as a complication of pulmonary tuberculosis in children
Marie Grobbelaar1, Savvas Andronikou, Pierre Goussard
1Department of Radiology, University of Stellenbosch and Tygerberg Hospital, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
Insights
Pulmonary tuberculosis is a rare cause of chylothorax, a condition with milky fluid in the chest. Tuberculous lymphadenopathy can obstruct the thoracic duct, leading to chylous effusions in children.
Area of Science:
- Pediatric Medicine
- Pulmonology
- Infectious Diseases
Background:
- Chylothorax, characterized by milky pleural effusions rich in triglycerides, is typically caused by malignancy or trauma.
- Pulmonary tuberculosis (TB) is an exceptionally rare etiology for chylothorax.
Observation:
- This report describes two pediatric cases of chylothorax secondary to pulmonary tuberculosis.
- One child presented with bilateral chylous effusions, while the other had unilateral effusions.
- Both patients exhibited extensive mediastinal and hilar lymphadenopathy.
Findings:
- Tuberculous lymphadenopathy can infiltrate and obstruct the thoracic duct and cisterna chyli.
- This obstruction likely increases lymphatic pressure, causing chyle to leak into the pleural space, resulting in chylothorax.
Implications:
- Highlights pulmonary tuberculosis as a potential, albeit rare, cause of chylothorax in children.
- Emphasizes the importance of considering infectious etiologies, particularly TB, in pediatric chylothorax with lymphadenopathy.
- Suggests a mechanism involving lymphatic obstruction by tuberculous lymph nodes leading to chylous effusions.
Abstract:
Chylothorax is a rare clinical entity characterized by a milky white aspirate with increased triglyceride levels. The commonest aetiology is malignancy and trauma. Pulmonary tuberculosis is an extremely rare cause of chylothorax. Two children with chylothorax and pulmonary tuberculosis are described. One child had bilateral and the other unilateral chylous effusions. Extensive mediastinal and hilar lymphadenopathy was demonstrated. Diseased lymph nodes may infiltrate other intrathoracic structures such as the thoracic duct, and they can also obstruct the cisterna chyli and thoracic duct. A possible explanation for the development of a chylothorax in our patients is obstruction of the thoracic duct by tuberculous lymphadenopathy with subsequent increase in pressure in the surrounding lymphatic system and leaking of chyle into the pleural space.
Related Concept Videos
Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:


